Sugimura M, Maeda M, Kawashima Y
Department of Obstetrics and Gynecology, Hamamatsu University School of Medicine.
Nihon Sanka Fujinka Gakkai Zasshi. 1988 Jun;40(6):747-53.
16 cases with gestational choriocarcinoma treated at our clinic from 1978 to 1987 were reviewed in connection with the surgical treatment for metastases in the brain and lung. 9 patients were classified as high risk, 5 patients as medium risk and 2 patients as low risk according to Bagshawe's prognostic score. An overall remission rate of 87.5% was achieved. 10 patients underwent surgical treatment with chemotherapy in 14 of 16 patients in whom metastases were identified, followed by complete remission. Pulmonary metastases were noted in 14 of 16 patients and lobectomy was performed in 10 of 14 patients, resulting in complete remission. Brain metastasis also was noted in 3 of 16 patients and the tumorectomy for the site of metastasis with irradiation was performed in 2 of the 3 patients, resulting in complete remission. One of 3 patients treated with chemotherapy alone, died. Our satisfactory results suggest the aggressive surgical therapy for the site of metastases in selected patients as indicated is apparently effective with vigorous systemic chemotherapy and radiotherapy.
回顾了1978年至1987年在我院治疗的16例妊娠滋养细胞肿瘤患者，探讨其脑和肺转移灶的外科治疗。根据Bagshawe预后评分，9例患者为高危，5例为中危，2例为低危。总缓解率达87.5%。16例中有转移灶的患者中，14例接受了手术治疗并联合化疗，其中10例患者随后完全缓解。16例中有14例出现肺转移，14例中的10例行肺叶切除术，均完全缓解。16例中有3例出现脑转移，3例中的2例在转移灶部位行肿瘤切除术并联合放疗，均完全缓解。单独接受化疗的3例患者中有1例死亡。我们令人满意的结果表明，对选定患者的转移灶进行积极的手术治疗，联合积极的全身化疗和放疗，显然是有效的。
